Provider Demographics
NPI:1619381738
Name:COSME, CHRISTINA
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:COSME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:CROMPOND
Mailing Address - State:NY
Mailing Address - Zip Code:10517-0655
Mailing Address - Country:US
Mailing Address - Phone:646-957-1625
Mailing Address - Fax:
Practice Address - Street 1:5 PAULDING LANE
Practice Address - Street 2:
Practice Address - City:CROMPOND
Practice Address - State:NY
Practice Address - Zip Code:10517
Practice Address - Country:US
Practice Address - Phone:646-957-1625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY448701101174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist